Doctor: Consultant’s Interim Order Conditions Revoked
A consultant nephrologist, currently the subject of fitness to practise proceedings brought by the GMC sought revocation of an interim order of conditions imposed upon him on the grounds that the IOT was wrong to consider an order was necessary to protect the public; the IOT was wrong to consider that an order was needed in the public interest, and that the order of conditions was disproportionate: RMD v General Medical Council [2026] EWHC 2684 (Admin) HHJ Karen Walden-Smith sitting as a Judge of the High Court
The GMC sought to rely upon a further witness statement together with lengthy exhibits provided by the doctor’s former wife, Ms B, which was not before the IOT.
The Court was able to consider additional evidence which was appropriate, and the evidence was relevant to the issues that the court must consider. It provided an account of the doctor’s sexual relationship with his former wife during the marriage and spoke to acts to which she said she did not consent. Additionally, there were three specific incidents mentioned, the third of which was after they had separated.
Her Ladyship admitted the statement for the purpose of the application.
The claimant provided numerous testimonials from patients and colleagues that spoke extremely highly of his qualities as a medic and the care and skill that he had exercised in his treatment of patients. His practice had most recently almost entirely as an independent self-employed consultant working for private organisations and for insurers. As a consequence of the IOT interim orders, his practice had been very severely impacted.
The doctor met Miss A on a dating app. Their relationship ended acrimoniously. Ms A reported to the police that she had been subjected to severe sexual violence at the hands of the claimant over a four-year period. The claimant was arrested and released on bail and immediately self-reported to the GMC.
As a result, the police contacted Ms B who at first made an allegation of rape against the doctor but later withdrew it accepting that it was consensual upon their wedding anniversary.
In interview, the doctor denied all the allegations, although he admitted to partaking in BDSM[1] but said it was consensual. At the conclusion of their investigations, the police decided to take no action. The doctor had still not been charged.
The only other information available to the IOT was an entry in redacted police records of a call to “Miss C” two years ago. There was no statement from Ms C and no evidence that she was making an allegation of rape.
The doctor challenged the imposition of conditions, including not to carry out face-to-face consultations with female patients, except in life-threatening emergencies, on three grounds: (1) that it was wrong to find that the conditions were necessary to protect the public; (2) that it was wrong to find that the conditions in the interim order were necessary in the public interest; (3) that the conditions imposed were not proportionate.
The MPTS Guidance provided that the test for imposing an interim order was whether it was necessary for the protection of the public or otherwise desirable in the interests of the public.
The allegations made against the doctor were with respect to his sexual behaviour in his private life. They were extremely serious allegations. There had been no suggestion on the part of the complainants that his behaviour involved his patients, albeit that the most recent evidence from Ms B suggested that the doctor had told her that he had sexual liaisons with colleagues whilst at the hospital in the ‘on call’ room.
The court referred to the helpful guidance provided by David Lock KC (Deputy HCJ) in NMC v Persand [2023] EWHC 3356 (Admin), where he set out: “… in every case the NMC committee and the court has to ask itself precisely why it is said to be ‘necessary’ to impose an interim sanction on the nurse. If the case is that it is necessary to protect the patients, then there needs to be an intense focus on how and why the evidence demonstrates that patients may be at risk from the nurse and how serious that risk is …
“Simply saying that, if a nurse was free to practise without being subject to conditions, such a circumstance would raise concerns in the minds of a member of the public is, in my judgment, wholly insufficient. Equally, saying that there is some limited risk to patients from a nurse’s clinical practise if he or she is allowed to continue to practice without restrictions is equally insufficient. It seems to me that the necessity test requires the NMC to show that, on the particular facts of a case, there are features of the case which mean that matters are so serious that it is justifiable to restrain the exercise of professional skills by a nurse at a stage when the allegations were unproven. The test is something close to saying that an interim order is essential, in the sense that a responsible regulator would not be acting properly in failing to act on a proven risk to the public.”
There was nothing before the IOT to suggest that there was any risk to patients and the allegations made by Ms A and Ms B with respect to the behaviour of the doctor gave no support to there being any such risk. The evidence from patients and colleagues was universally positive and utterly undermined any suggestion of risk.
The legally qualified chair incorrectly cited X v General Medical Council [2019] 493 (Admin) when it should have been Dr X v GMC [2001] EWHC (Admin) but, in any event, that case dealt with different issues. The cases provided no authority for what she set out.
The IOT was obliged to consider if there were risk, and whether that risk was real and immediate. The IOT misdirected itself as to the appropriate test which was not contained in either of the above cases and which was compounded by incorrect references to R (Kuzmin) v GMC [2023] EWHC 60 (Admin)which was dealing with the issue of adverse inferences, and Wray/Ray v GMC which was not a recognised authority.
There were two fundamental errors in the panel’s reasoning: first, the IOT seemed to have placed reliance on an allegation being made by Ms C and, second, they relied on allegations about the doctor’s private behaviour without any evidence to support that impacting his behaviour in a clinical setting.
The second ground for imposing the order was that it was in the public interest. There was a high bar to be met for imposing an order on that ground: Sheikh v General Dental Council [2007] EWHC 2972 (Admin).
The IOT did not take into account, sufficiently or at all, the wider picture that when considering public interest account needed to be taken of the fact that the allegations were said to have occurred in a domestic context; that after investigation the police decided that the evidential threshold had not been met, and that the doctor had never been charged with any matter; the doctor’s exemplary record as a surgeon and physician; and that there was no evidence to support the doctor posing a real or immediate risk to any patient.
Had the court not already found that the IOT was wrong to impose conditions based upon public protection and public interest, her Ladyship would have ordered that the conditions be set aside on the ground that they were not proportionate.
The conditions were revoked.
[1] Bondage, discipline and sado-machism)